Does My Loved One Have an Eating Disorder?
Introduction to Restrictive Eating Disorders
There is no one way restrictive eating disorders look, nor is there one way young people struggling with eating disorders look. “Eating disorders are serious but treatable mental and physical illnesses that can affect people of every age, sex, gender, race, ethnicity, and socioeconomic group. National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives.” -NEDA
Know the difference between disordered eating patterns and an eating disorder. Disordered eating includes shorter term problematic or even highly risky eating behaviors, where as an eating disorder has specific clinical criteria, and is best diagnosed by a specialist. Disordered eating is quite common in children and adolescents, in one study as many as 30% of middle school girls noted engaging in these behaviors (Austin et al, 2008). Despite this, disordered eating often will resolve without specialized intervention, though in some cases this can lead to an eating disorder. On the other hand, an eating disorder (ED) impairs social, familial, emotional, physiologic, academic, and/or academic functioning, and does not spontaneously resolve. Some of the signs can be extreme food restriction or refusal, substantial weight changes (regardless of BMI), purging, laxative abuse, and over-exercising. There are many name for restrictive eating disorders - ARFID, anorexia nervosa, atypical anorexia nervosa, OSFED, bulimia nervosa, and unspecified feeding and eating disorder.
KEY POINT: Eating disorders are serious psychological illnesses that lead to severe medical problems.
Your family member is not their illness. It is critical to remind yourself, and your loved one, that they are not their eating disorder. This will be challenging at times, because many people struggling with restrictive eating disorders feel quite the opposite, even identifying themselves and aligning themselves with their ED. Helping note, with kindness and compassion, times when you are hearing the eating disorder, not your healthy family member, speaking can be a critical therapeutic tool.
KEY POINT: Your noncritical acceptance of your loved one, as you fight their eating disorder, is vital in supporting their progress towards wellness.
Inform yourself and your family member about the life-threatening risks of an untreated restrictive eating disorder. Cardiovascular complications: heart muscle breakdown, heart rate changes, electrolyte changes, risk for heart valve changes, risk for heart failure, risk for heart rhythm changes, risk for death. Gastrointestinal complications: gastroparesis, constipation, pancreas inflammation, discomfort with eating. Neurological complications: Brain starvation, obsession with food, poor concentration, sleep problems, dizziness, fainting, positional lightheadedness, muscle cramps, numbness/tingling in hands & feet, or seizures. Endocrine complications: abnormally low hormonal levels, osteopenia/osteoporosis, hypothermia, increased risk for bone fractures, up to 6x increase in scoliosis risk (Zaina et al, 2017). Other complications: Dry skin, brittle hair, hair loss, long downy hair growth on body (lanugo), decreased blood count, fatigue, poor immune function.
KEY POINT: Untreated eating disorders are a high mortality illness.
You are a critical part of your family member’s treatment. You are coach, supporter, therapist, role model and limit-setter. Just as you did when your family member was very young, you are now part of the team (or the main entity if you are their primary guardian) renourishing them.
KEY POINT: Eating disorder treatment is a journey, this could be your first step.
